Smoking and Obesity — Power and Deep Pockets

Of necessity — because few other institutions can afford to dispense such largesse — actions meant to stem the tide of obesity are often wholly or partly run by the government. For one example, scientists led by Dr. Jonathan Bricker have, since 2013, been immersed in $14 million worth of research financed by the National Institutes of Health.

Dr. Bricker, a psychologist and public health researcher at Fred Hutchinson Cancer Research Center, speaks of the need for interventions “that also focus on increasing self-efficacy, positive reinforcement and treatment strategies.” He is talking about Acceptance and Commitment Theory (ACT). In the words of reporter Mary Engel,

ACT focuses on increasing one’s willingness to accept the physical, mental and emotional challenges of quitting while also encouraging commitment to engage in values-based behavior change…

First, there was a five-year study comparing the effectiveness of web-delivered ACT to the smoking cessation intervention. Next, the team tested an ACT smoking cessation website designed specifically for patients with bipolar disorder.

Two discrete five-year randomized controlled trials will both wind up next year. Their goals are described thusly:

To compare the effectiveness of telephone-delivered ACT against traditional cognitive behavioral therapy for smoking cessation intervention.

To compare the effectiveness of a smartphone-delivered ACT application against a smartphone-delivered US Clinical Practice Guidelines application… Aims include testing cost effectiveness.

Smoking and obesity are so closely associated because what helps to defeat one might also vanquish the other. Such is the hope, anyway, including among these researchers, and indeed we are told they are also “developing a separate line of research focusing on innovative behavioral approaches to weight loss.”

The failed experiment where n is a very large number

Even the government is susceptible to the law of unintended consequences. Its persuasive efforts do not always work, and sometimes backfire. In 1984 (very appropriately, according to some observers) the DARE program got underway in public schools. Fast-forward to 2003, when…

[…] the US Government Accountability Office concluded that the program generated a boomerang effect: those who participated in DARE proceeded to have above-average rates of drug use. This finding was given traction by a University of Indiana study that found that students completing the program had higher rates of hallucinogenic drug use than those who had not taken part.

To recap: For nearly two decades, 26 million American kids and 10 million in other countries were subjected to a program that turns out to be not only useless, but harmful. As an analogy, imagine a pharmaceutical compound being released, touted as safe and effective, and foisted on 36 million minor children — until finally, someone admits that “This stuff does the opposite of what it’s supposed to.”

Your responses and feedback are welcome!

Source: “Jonathan B. Bricker, PhD,”
Source: “Smoking stigma can backfire, hurt efforts to quit,”, 11/02/15
Source: “Overcoming obesity: An initial economic analysis,”, November 2014
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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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